Active NPI
Stephanie Gordon, M.D.
- Family Medicine Physician
- Chillicothe, OH
National Provider Identifier
1952465437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35-073667
- Practice address
- 17273 State Route 104
Blue Team (11C)
Chillicothe, OH 45601-8605 - Phone
- (740) 773-1141
- Fax
- (740) 772-7077
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35-073667 | OH | Primary |
Addresses
Primary practice location
17273 State Route 104
Blue Team (11C)
Chillicothe, OH 45601-8605
Mailing address
17273 State Route 104
Chillicothe, OH 45601-8608
Phone (740) 773-1141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-073667 | OH | MD | Family Medicine Physician |
Practice roles
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1952465437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456018608",
"telephone_number": "740-773-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"address_2": "BLUE TEAM (11C)",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456018605",
"telephone_number": "740-773-1141",
"fax_number": "740-772-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35-073667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chillicothe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.